Disseminated Congenital Tuberculosis in Neonates: A Case Series

Area of Science:

• Neonatology
• Infectious Diseases
• Pediatric Radiology

Background:

• Congenital tuberculosis (CTB) is a rare condition with non-specific clinical presentations, complicating diagnosis in neonates.
• Distinguishing CTB from postnatal infection and managing non-specific newborn symptoms contribute to diagnostic challenges.
• Delayed diagnosis of CTB, despite its low incidence, is associated with significant mortality.

Purpose of the Study:

• To present two cases of congenital tuberculosis in newborns.
• To highlight the diagnostic challenges and the importance of high clinical suspicion for CTB.
• To emphasize the need for timely diagnosis and treatment to improve outcomes.

Main Methods:

• Case report of two neonates diagnosed with congenital tuberculosis.
• Diagnostic workup included chest computed tomography, brain MRI, and cerebrospinal fluid studies.
• Diagnosis was supported by intrauterine growth restriction and maternal history of active tuberculosis.

Main Results:

• Both neonates presented with signs of disease within the first few days of life.
• Imaging and laboratory findings, along with clinical context, aided in suspecting CTB.
• Non-response to standard treatments further indicated a diagnosis of CTB.

Conclusions:

• Congenital tuberculosis requires a high index of suspicion in neonates, especially with a maternal history of tuberculosis.
• Multimodal diagnostic approaches are essential for timely CTB diagnosis.
• Prompt initiation of appropriate treatment is critical for improving survival and outcomes in congenital tuberculosis.